Individual provider Active NPI

Leslie Christine Henson, DMD

  • Dentist
  • Fort Mill, SC
National Provider Identifier
1750461422
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3416 Issued in SC
Practice address
765 Crossroads Plaza
Fort Mill, SC 29708
Phone
(803) 396-7833
Fax
(803) 396-7834
NPI assigned
Oct 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3416 SC Primary

Addresses

Primary practice location

765 Crossroads Plaza
Fort Mill, SC 29708

Mailing address

3717 Selwyn Farms LN
Charlotte, NC 28209
Phone (704) 521-8870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3416SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Dental Office at Fort Mill Past Accepting new patients
The Dental Office at Fort Mill Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750461422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 SELWYN FARMS LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28209",
            "telephone_number": "704-521-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 CROSSROADS PLAZA",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29708",
            "telephone_number": "803-396-7833",
            "fax_number": "803-396-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "LESLIE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "3416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.